Abstract
Starting with a handful of SARS-CoV-2 infections in dormitory residents in late March 2020, rapid transmission in their dense living environments ensued and by October 2020, more than 50,000 acute infections were identified across various dormitories in Singapore. The aim of the study is to identify combination of factors facilitating SARS-CoV-2 transmission and the impact of control measures in a dormitory through extensive epidemiological, serological and phylogenetic investigations, supported by simulation models. Our findings showed that asymptomatic cases and symptomatic cases who did not seek medical attention were major drivers of the outbreak. Furthermore, each resident had about 30 close contacts and each infected resident spread to 4.4 (IQR 3.5–5.3) others at the start of the outbreak. The final attack rate of the current outbreak was 76.2% (IQR 70.6–98.0%) and could be reduced by further 10% under a modified dormitory housing condition. These findings are important when designing living environments in a post COVID-19 future to reduce disease spread and facilitate rapid implementation of outbreak control measures.
Highlights
Starting with a handful of SARS-CoV-2 infections in dormitory residents in late March 2020, rapid transmission in their dense living environments ensued and by October 2020, more than 50,000 acute infections were identified across various dormitories in Singapore
Urban settings such as cities are vulnerable to COVID-19 spread as close-living environments generally lead to higher degrees of social interactions which contribute to communicable disease s pread[4,5]
Five of the cases were each identified to be associated with at least one other COVID-19 cluster occurring in three worksites and a commercial area frequented by foreign workers
Summary
Starting with a handful of SARS-CoV-2 infections in dormitory residents in late March 2020, rapid transmission in their dense living environments ensued and by October 2020, more than 50,000 acute infections were identified across various dormitories in Singapore. The final attack rate of the current outbreak was 76.2% (IQR 70.6–98.0%) and could be reduced by further 10% under a modified dormitory housing condition These findings are important when designing living environments in a post COVID-19 future to reduce disease spread and facilitate rapid implementation of outbreak control measures. A surge of COVID-19 cases was identified across multiple foreign worker dormitories—the place of residence for about a quarter of the 1.4 million foreign workers in Singapore[7,8] These dormitories were built with features such as common recreational and shared facilities, such as gyms, outdoor game courts, minimarts, and cooking a reas[9]. Details of the respective interventions in each scenario are described in the Supplementary Information
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